Category: Centers for Medicare & Medicaid Services

PDGM’s Base Rates Set 5.76% Below Budget-Neutral Levels, Analysis Finds

Centers for Medicare & Medicaid Services, Home Health Care, Legislation, Partnership for Quality Home Healthcare / September 2, 2021 September 2, 2021

The public comment period for the U.S. Centers for Medicare & Medicaid Services’ (CMS) home health proposed payment rule closed last week. Since then, the industry has voiced more substantive concerns with the rule than initially expected. The Partnership for Quality Home Healthcare (PQHH), for instance, recently released its own perspective, which was driven by …

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CMS Study Shows Astonishing Disparity Between COVID-19 Cases in Nursing Homes and the Community

Centers for Medicare & Medicaid Services, CMS, Legislation, National Association for Home Care & Hospice / August 25, 2021 August 25, 2021

A recently published study by the U.S. Centers for Medicare & Medicaid Services (CMS) is sure to add more fuel to the fire for the “Choose Home” initiative and other movements aiming to bring more care into the home. Specifically, the study found that although nursing home residents only represent 2% of the Medicare population, …

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‘It’s Just Wrong on Every Level’: Home Health Insiders Object to Review Choice Demonstration Details

Centers for Medicare & Medicaid Services, CMS, Featured, Healthcare Provider Solutions, HHCN+, Home Health Care, Legislation, Parker Poe / August 23, 2021 August 23, 2021

The rollout of the U.S. Centers for Medicare & Medicaid Services’ (CMS) Review Choice Demonstration (RCD) has been anything but smooth. The initiative implemented to reduce improper billing and fraud in select states has been plagued by issues like COVID-19-related delays and missteps by CMS and its contractors, among others. Despite the flaws, the demo …

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CMS Taking ‘Laissez-Faire’ Approach to Direct Contracting

Centers for Medicare & Medicaid Services, CMS, innovation, Legislation, Signify Health, The Centers for Medicare and Medicaid Innovation / June 30, 2021 June 30, 2021

Signify Health’s (NYSE: SGFY) leaders are as cautiously optimistic and encouraged by the prospects of direct-contracting models as almost anyone. For now, Signify works with the government to give the Centers for Medicare & Medicaid Services (CMS) insight on how the models could work in the future. The company also works with adjacent organizations that …

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CMS Proposes $310M Home Health Payment Boost, National Expansion of HHVBP

Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, Featured, Home Health Care, Legislation / June 28, 2021 June 28, 2021

The U.S. Centers for Medicare & Medicaid Services (CMS) on Monday proposed plans to expand the Home Health Value-Based Purchasing (HHVBP) model nationwide by the start of next year. The agency did so in its proposed payment rule for 2022. In addition to the HHVBP expansion, CMS proposed to increase Medicare payments to home health …

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‘A Unique Opportunity for Home Health Providers’: CMS Extends CJR Model

Centers for Medicare & Medicaid Services, CMS, Home Health Care, Simione Healthcare Consultants / May 4, 2021 May 4, 2021

The U.S. Centers for Medicare & Medicaid Services (CMS) has extended the Comprehensive Care for Joint Replacement (CJR) payment model. That’s welcome news for home health operators, as CJR has been a key program for participating agencies since its implementation. Introduced in 2016, CJR essentially allows CMS to hand out bonuses or inflict payment penalties …

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Direct-Contracting Entities Figuring Out How to Capitalize on Competitive Advantage

ATI Advisory, Centers for Medicare & Medicaid Services, CMS, Legislation, Lifesprk / May 3, 2021 May 3, 2021

A delay in the Global and Professional Direct Contracting Model by the Biden administration has put the already-accepted direct-contracting entities (DCEs) in a coveted position. New entrants are no longer being accepted for participation in the model while the Centers for Medicare & Medicaid Services (CMS) and its innovation arm review the details. That gives …

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Confirmation Delay for Next CMS Administrator Could Cause Problems for Home-Based Care Providers

Centers for Medicare & Medicaid Services, CMS, Legislation, National Association for Home Care & Hospice / April 21, 2021 April 21, 2021

It has been over three months since former Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma resigned from her post. As of Wednesday, no one has officially filled the position’s void. The Biden administration’s pick for administrator, Chiquita Brooks-LaSure, has yet to be confirmed by the Senate due to ongoing partisan disputes. For …

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Allegheny Health Network Expands Hospital-at-Home Program as CMS Waiver Total Hits 80

Allegheny Health Network, Centers for Medicare & Medicaid Services, Featured, Highmark Health, Home Health Care, innovation / January 13, 2021 January 13, 2021

The Acute Hospital Care At Home initiative from the U.S. Centers for Medicare & Medicaid Services (CMS) now has at least 80 participants, Administrator Seema Verma announced Wednesday. Unveiled in November, the initiative has been growing rapidly, especially of late. On its end, CMS hopes the emerging hospital-at-home models can increase acute care capacity and …

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An ‘Awkward Transition Year’: Why 2021 Will Look Different in Home Health with New RAP Adjustments

Centers for Medicare & Medicaid Services, CMS, Home Health Care, McBee Associates / November 22, 2020 November 22, 2020

The U.S. Centers for Medicare & Medicaid Services (CMS) issued its final 2021 home health payment rule in late October. When it came out, some providers were less than pleased. On one hand, the Patient-Driven Groupings Model (PDGM) wasn’t substantially altered to balance out its flawed behavioral assumptions. On another, there are also a few …

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More Than Half of All Home Health Agencies Have Treated COVID-19 Patients

Centers for Medicare & Medicaid Services, CMS, Home Health Care, NAHC, National Association for Home Care & Hospice / August 25, 2020 August 25, 2020

The U.S. Centers for Medicare & Medicaid Services (CMS) officially closed its public comment window for the 2021 proposed home health payment rule on Monday. Unlike the past couple of years, the latest proposed payment rule included relatively minor changes and rate adjustments for the year ahead. In light of the mild proposal, CMS only …

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Senator Kirsten Gillibrand Pushes for Increased PPE, Telehealth Payment for In-Home Care Providers

Centers for Medicare & Medicaid Services, CMS, Home Health Care, Personal Home Care, The Department of Health and Human Services, Visiting Nurse Service of New York / August 24, 2020 August 24, 2020

U.S. Senator Kirsten Gillibrand (D-NY) is asking the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) to ensure that in-home care providers have access to essential resources amid the coronavirus. Throughout the public health emergency, home health and home care providers have been vocal about the challenges …

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‘I’m Not Sure Their Timing Could Be Any Worse’: CMS to Resume Review Choice Demonstration

Centers for Medicare & Medicaid Services, CMS, Concierge Home Care, Featured, NAHC, National Association for Home Care & Hospice, Parker Poe / July 9, 2020 July 9, 2020

The U.S. Centers for Medicare & Medicare Services (CMS) announced Tuesday that the Review Choice Demonstration (RCD) would be renewed for participating states beginning in August. The RCD was suspended in late March due to the COVID-19 crisis, but now CMS is planning on moving forward with the demonstration “regardless of the status of the …

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